Borrowing Card Application

Please fill in the entire form; otherwise, your request cannot be processed. By submitting this form you accept full responsibility for all materials charged out to your account from the State Library of Louisiana. By submitting this form you state that you are a state employee, retired state employee or a student of the Library School. You agree to be responsible for returning materials within the loan period granted and you are liable for the cost of replacing lost or damaged materials charged out to your account.

If you have any questions, please contact the Circulation Department office at 225-342-4915 or circ@library.la.gov.

Last Name: *

First Name: *

Date of Birth: *

Employee ID number

Email Address: *

State Agency Name: *

Office Address:

Work City:

Work State:

Work Zip Code:

Office Telephone:

Home Address:

Home City:

Home State:

Home Zip Code:

Home Telephone:

Check the appropriate category: *

Permanent Employee
Temporary Employee
Retired Employee
Student Worker
Currently enrolled Louisiana State University School of Library and Information Science Graduate Student
Contractors currently under contract with a Louisiana state agency
Currently credentialed member of the media

Date Contract Expires *

Agency Retired From: *

Date Employment Ends: *

Agency: *

If you wish to allow others to use your library card, you must visit the State Library and inform the Circulation staff.

You do not need to have an actual borrower card to access the databases or to borrow materials from the State Library. A card number will suffice. Some people prefer to have an actual card. If you would like to receive one at your office address, please check the appropriate box.

Would you like a card mailed to your office?

Yes, I would like a borrower card mailed to me at my office address.

Acknowledgment *

I understand that by submitting this form I confirm that all information is correct and I accept full responsibility for all materials charged out to my account from the State Library of Louisiana. I agree to be responsible for returning materials within the loan period granted and I am liable for the cost of replacing lost or damaged materials charged out to my account.